What’s Best for Dandruff That Won’t Go Away?

Q: What do you recommend for resistant dandruff?

A: Skin or scalp dandruff (also called seborrheic dermatitis) is very common. In fact, about 11% of the population has this condition. We see it not just on the scalp, but also on the eyebrows, around the nose, on the ears and chest and around the mouth. Having dandruff doesn’t mean the skin is dirty or infected.

Typically, we first treat seborrheic dermatitis with anti-dandruff shampoos that you can buy over the counter. For resistant cases, however, we may prescribe an antifungal product called ketoconazole (Nizoral®), available in a 2% formulation as a shampoo or cream. We may also prescribe you medicated foam, cream or solution.

What’s most important is to realize that this condition is intermittent and chronic — meaning it comes and goes over long periods of time. Continuing to use the medications recommended to you will help minimize the recurrence of this otherwise chronic condition.

— Dermatologist Christine Poblete-Lopez, MD